Prevention and Control of STD Related Morbidity, the application of The University of Alabama at Birmingham (UAB) to become an STD CRC, is a coordinated, multidisciplinary effort whose overall aim is to expand understanding regarding STDs in areas which have the potential to augment existing efforts to reduce the morbidity and human suffering caused by STDs. Investigators from nine different Departments in two Schools (Medicine and Public Health) at UAB, the Jefferson County Alabama Department of Health and the University of Rhode Island will participate in six projects: (i) To comprehensively evaluate the microbial etiology of nongonococcal urethritis in men for the first time in over 20 years using more sensitive detection methods for known pathogens and recently developed methods for detection of newly described potential pathogens. (ii) To prospectively evaluate microbial and behavioral contributors to the pathogenesis of bacterial vaginosis and to carefully evaluate the interaction of this common problem with risk for acquisition of gonorrhea, chlamydia or trichomonas infections. (iii) To evaluate a targeted, theoretically based behavioral intervention to reduce risk for recurrent urethritis among men in a randomized, prospectively conducted clinical trial. (iv) To comprehensively evaluate both mucosal and systemic immune responses to Chlamydia trachomatis infections in men and women with initial and repeated chlamydia infections. (v) To extend locally generated data regarding the role of Ureaplasma urealyticum and other microorganisms in the causation of premature (<34 weeks) labor to now evaluate the role of these organisms in the causation of second trimester spontaneous abortion and very early (20-29 weeks) premature labor and (vi) to study the molecular epidemiology of human papillomavirus (HPV) infections and the molecular events related to the causal role of HPV in genital tract malignancy in two groups of immunosuppressed women (renal transplant recipients and women with HIV infection) at particular risk for accelerated progression of disease. These investigations will be supported by a Biostatistical/Administrative Core and a Clinical Core project which supports Projects 1-4. This grant will serve as a focal point for an STD Center at UAB which will promote interdisciplinary research on STD pathogenesis epidemiology and control.